Girls make a comeback: India’s skewed sex ratio at birth begins to normalize


Bias for sons declines sharply among Sikhs, while Christians continue to have a natural balance of sons and daughters

India’s artificially-created huge difference between the number of baby boys born as compared to baby girls – which arose in the 1970s due to the use of prenatal diagnostic technology to facilitate sex-selective abortions – now appears to be narrowing.

A Pew Research Center analysis of newly released data from India’s National Family Health Survey (NFHS) suggests that Indian families are now less likely to use abortions to ensure the birth of sons rather than daughters.

This follows years of efforts by the government to curb sex selection – including a ban on prenatal sex tests and a massive, ongoing advertising campaign urging parents to “save the girl child”. This factor coincides with broader social changes such as rising education and wealth.

“Naturally, boys modestly outnumber girls at birth, at a ratio of approximately 105 male babies for every 100 female babies. That was the ratio in India in the 1950s and 1960s, before prenatal sex tests became available across the country. Abortion was legalized in the country in 1971,” the report states.

Once prenatal testing allowed Indian families to learn the sex of a fetus during pregnancy, sex selection took off. The sex ratio at birth widened rapidly from about 105 boys per 100 girls before 1970, to 108 boys per 100 girls in the early 1980s; it reached 110 in the 1990s and stubbornly remained at that level for roughly 20 years, despite government efforts to curb the use of ultrasound tests for sex selection.

From a large imbalance of about 111 boys per 100 girls in India’s 2011 census, the sex ratio at birth appears to have normalized slightly over the last decade, narrowing to about 109 in the 2015-16 wave of the National Family Health Survey and to 108 boys in the latest wave of the NFHS, conducted from 2019-21.

Nonetheless, a Pew Research Center analysis of United Nations estimates reveals that during the two decades between 2000 and 2020, India on average had one of the world’s most skewed sex ratios at birth, after Azerbaijan, China, Armenia, Vietnam, and Albania.

“Even though it has been illegal in India since 1996 for doctors and other medical practitioners to reveal the sex of a fetus to the prospective parents, at least 9.0 million (0.9 crore) female births went “missing” between 2000 and 2019 because of female-selective abortions,” according to a Pew Research Center analysis of data from multiple waves of the NFHS and India’s census.

To put the recent decline in sex selection into perspective, the average annual number of baby girls “missing” in India fell from about 480,000 (4.8 lakh) in 2010 to 410,000 (4.1 lakh) in 2019, the Center’s analysis finds. (“Missing” refers to an estimate of how many more female births would have occurred during this time if there were no female-selective abortions.)

In the past, some of India’s major religious groups varied widely in their sex ratios at birth, but today there are indications that these differences are shrinking. Sikhs, who in past decades had a particularly large imbalance of baby boys to girls, now seem gradually to be moving toward the natural level, as well as converging with other groups. (The report focuses on India’s four biggest religious groups with sufficient sample sizes to allow for a reliable analysis of sex ratios at birth: Hindus, Muslims, Christians, and Sikhs.)

“In the 2001 census, Sikhs had a sex ratio at birth of 130 males per 100 females, far exceeding that year’s national average of 110. By the 2011 census, the Sikh ratio had narrowed to 121 boys per 100 girls. It now hovers around 110, about the same as the ratio of males to females at birth among the country’s Hindu majority (109),” the latest NFHS has highlighted.

In recent decades, Christians also have stood out from India’s other religious groups, but in the opposite direction. India’s Christian minority has maintained a sex ratio at birth around the natural level of 105 boys per 100 girls, indicating a relatively low incidence of sex-selective abortion in the Christian community. Indian Muslims also now have a sex ratio at birth (106) that is close to the natural norm seen in India prior to the introduction of prenatal testing.

Even if India’s sex ratio at birth continues to normalize, the large number of girls “missing” from its population could continue to have profound consequences on Indian society for decades to come.

“Sikhs, in particular, face an acute shortage of single women of marriageable age. Sikhs make up less than 2% of the Indian population but accounted for an estimated 5%, or approximately 440,000 (4.4 lakhs), of the 9.0 million baby girls who went “missing” in India between 2000 and 2019,” the report says.

“The share of “missing” girls among Hindus is also above their respective population share. Hindus make up 80% of India’s population but accounted for an estimated 87%, or approximately 7.8 million (78 lakhs), of the females “missing” due to sex-selective abortions,” the report adds.

The share of female births “missing” among the remaining religious groups during this period is lower than each group’s share of the Indian population, meaning they were less likely than others to engage in sex-selective abortions. Muslims, who make up about 14% of India’s population, accounted for 7%, or approximately 590,000 (5.9 lakhs), of the country’s “missing” girls. Christians, who make up 2.3% of the population, have had an estimated 0.6%, or about 53,000 (0.5 lakh), of the total number of sex-selective abortions.

The new report does not attempt to determine the exact causal connections between religion and family choices. Its main goals are to describe the childbearing patterns and attitudes revealed in Indian census data and in surveys and to use statistical techniques to show how these patterns vary by religion.

The rest of the report takes a closer look at each of the dynamics that underlie sex selection – namely son preference, ultrasound use, and fertility – including a detailed analysis of trends in each of the major religious groups and across India’s six administrative regions.

The report was produced by Pew Research Center as part of the Pew-Templeton Global Religious Futures project, which analyzes religious change and its impact on societies around the world. Funding for the Global Religious Futures project comes from The Pew Charitable Trusts and the John Templeton Foundation.

Abortion laws and practices in India

Abortion is legal in India up to the 24th week of pregnancy under a range of criteria, including saving a woman’s life. Abortions are allowed after the 24th week if a medical board of at least three experts detects “substantial fetal abnormalities.”

However, the use of ultrasound devices and other technologies to determine the sex of fetuses is prohibited, and violators – including family members who seek this information and medical personnel who provide it – face fines and even imprisonment.

It is difficult to know exactly how many abortions take place in India each year because the stigma surrounding abortions leads to serious underreporting. For example, while the most recent National Family Health Survey finds that around 3% of pregnancies in India end with abortion in any given year, academic researchers often estimate the number to be much higher.

A 2018 study published in The Lancet suggests that roughly half of pregnancies in India are unintended and that there were 15.6 million (about 1.6 crore) induced abortions in 2015 alone – roughly one-third of all pregnancies that year. The 2018 study finds that most abortions in India take place using medications outside of health facilities. (Such medications are commonly purchased at pharmacies or from informal vendors.)

It is likely that sex-selective procedures account for only a small fraction of all abortions in India, given that about 9.0 million (0.9 crore) sex-selective abortions were performed between 2000 and 2019, according to Pew Research Center’s estimate.